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Single nucleotide polymorphisms (SNPs) in certain genes play a role in the observed variability in development and severity of acute respiratory distress syndrome (ARDS). Identified SNPs can direct future studies aiming to target diagnostic, preventive, and therapeutic interventions for the complex pathophysiology of ARDS [1]. For example, CFTR is involved in fluid absorption from alveoli and in negatively modulating the inflammatory response [2, 3], and Perez-Marques et al. report that SNPs in DNA for proteins involved in splicing in the exon 9 region of CFTR mRNA were independently associated with risk for ARDS [2]. The same group have identified other statistically significant candidate gene associations with the risk for pediatric ARDS (Table 1) [2–7]. In adults, other candidate gene associations with risk for development of and outcome from ARDS have been suggested [1, 8]. How should these gene-association hypotheses be interpreted?

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Interpretation of gene associations with risk of acute respiratory distress syndrome: P values, Bayes factors, positive predictive values, and need for replication